| NPI | 1972611713 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 004405-040806)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 6404)  | 
| 101YM0800X Counselor, Mental Health (Licence: TX 10158)  | |
| Enumeration Date | 2006-08-29 | 
| Last Update Date | 2025-09-11 |