| NPI | 1689565467 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 206081) |
| Additional Taxonomies | 225600000X Dance Therapist (Licence: 2937) |
| Enumeration Date | 2025-07-10 |
| Last Update Date | 2025-07-10 |