| NPI | 1649264078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 4671) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 2585) |
| 101Y00000X Counselor (Licence: TX 4671) | |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2007-07-08 |