| NPI | 1649324815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 63296) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH8929) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2018-03-17 |