| NPI | 1689056863 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 70471) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OK 12104) | 
| 101YP2500X Counselor, Professional (Licence: TX 70471) | |
| Enumeration Date | 2015-06-24 | 
| Last Update Date | 2025-02-20 |