| NPI | 1710508288 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 79059) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 79059) | 
| Enumeration Date | 2020-05-06 | 
| Last Update Date | 2024-05-25 |