Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 62526 | TX |
NPI | 1003089863 |
---|---|
Provider Name | Karina Shroff |
First Address | Dallas, TX 75204-1442 |
Second Address | Dallas, TX 75235-2215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2008 |
Last Update Date | 11/04/2008 |