NPI | 1962076687 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 78176) |
Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: TX 550994) |
Enumeration Date | 2021-05-17 |
Last Update Date | 2024-06-14 |