| NPI | 1750663688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 64264) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 64264) |
| Enumeration Date | 2011-09-16 |
| Last Update Date | 2022-04-04 |