| NPI | 1902036833 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 56345)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 078080-1)  | 
| 101YM0800X Counselor, Mental Health (Licence: MA 118460)  | |
| 101YM0800X Counselor, Mental Health (Licence: TX 56345)  | |
| Enumeration Date | 2009-07-27 | 
| Last Update Date | 2015-07-06 |