| 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 |