| NPI | 1962045906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 61392) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101Y00000X Counselor | |
| 104100000X Social Worker (Licence: TX 61392) | |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2019-10-22 |