| NPI | 1710074091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 17622) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 3506) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2011-10-14 |