NPI | 1669682258 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: TX 36936) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 61423) |
101Y00000X Counselor (Licence: TX 61423) | |
103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: TX 34976) | |
Enumeration Date | 2007-05-23 |
Last Update Date | 2021-08-04 |