| NPI | 1760575856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 60133) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 60133) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2015-07-01 |