| NPI | 1821007113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 39303) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 25440) |
| 101YP2500X Counselor, Professional (Licence: TX 25440) | |
| 1041C0700X Social Worker, Clinical (Licence: TX 25440) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2022-12-28 |