| NPI | 1003457219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 93424) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CO LPC.0019687) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO ACD.0001913) | |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2024-04-08 |