| NPI | 1972987584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 63694) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 081895) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2018-03-17 |