| NPI | 1821002395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX LPC11500) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LMFT003206) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2014-01-08 |