| NPI | 1801352380 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 11658796-6004)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-31477)  | 
| Enumeration Date | 2019-02-20 | 
| Last Update Date | 2020-07-07 |