| NPI | 1962873125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 72081) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 72081) |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2015-10-14 |