| NPI | 1972577260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 10486) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 000462-041982) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 225094) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2007-07-08 |