| NPI | 1639546492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 5647) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 81574) |
| Enumeration Date | 2015-08-27 |
| Last Update Date | 2021-09-07 |