| NPI | 1700167293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 63083) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 63083) |
| 101YM0800X Counselor, Mental Health (Licence: TX 63083) | |
| Enumeration Date | 2011-08-29 |
| Last Update Date | 2011-12-11 |