| NPI | 1740405091 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 12110)  | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 12110)  | 
| Enumeration Date | 2007-04-13 | 
| Last Update Date | 2010-01-29 |