| NPI | 1891719944 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 2120) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 14015) | 
| 106H00000X Marriage & Family Therapist (Licence: LA 975) | |
| Enumeration Date | 2006-07-26 | 
| Last Update Date | 2012-09-20 |