| NPI | 1790384725 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 64069) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 64069) | 
| Enumeration Date | 2020-10-21 | 
| Last Update Date | 2023-02-21 |