| NPI | 1649548074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 17892) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: TX 1-11-8031) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |