| NPI | 1871152413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 75189) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 202504) |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2022-05-30 |