| NPI | 1770864589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TX 8983) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TX 3117) |
| Enumeration Date | 2011-09-07 |
| Last Update Date | 2011-09-07 |