| NPI | 1679624175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 1986) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 16986) |
| 106H00000X Marriage & Family Therapist (Licence: LA 560) | |
| Enumeration Date | 2007-01-13 |
| Last Update Date | 2013-05-13 |