| NPI | 1962497750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TX 14561) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 14531) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2007-07-08 |