| NPI | 1639601230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 72802) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 72802) |
| Enumeration Date | 2017-04-02 |
| Last Update Date | 2017-04-02 |