| NPI | 1730302563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 62267) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OR C3250) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2021-04-01 |