| NPI | 1689672073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 18292) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 003042008541) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2008-06-23 |