| NPI | 1750685319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 64295) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 695) |
| Enumeration Date | 2010-12-22 |
| Last Update Date | 2019-02-01 |