| NPI | 1033221726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 5564) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: TX 111049) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |