| NPI | 1912205824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 7627014-6004) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: UT 7627014-6009) |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2019-10-04 |