| NPI | 1811995707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 10049) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 002656-040904) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2007-07-08 |