| NPI | 1780017475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 40236) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 69910) |
| 101YP2500X Counselor, Professional (Licence: TX 69910) | |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2025-01-16 |