| NPI | 1679041917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 75778) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 75778) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: TX 75778) | |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2024-02-08 |