| NPI | 1912283128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 68430) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO 0011857) |
| 251S00000X Community/Behavioral Health (Licence: TX 68430) | |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2021-05-14 |