| NPI | 1801804984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MT BBH-LCPC-LIC-16607) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 17637) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2017-03-23 |