| NPI | 1679649057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 4615) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 16646) |
| 101YP2500X Counselor, Professional (Licence: MT 851LCPC) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2007-07-08 |