| NPI | 1033462023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 69483) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12087) |
| 101Y00000X Counselor (Licence: TX 69483) | |
| 225C00000X Rehabilitation Counselor (Licence: IL 00114258) | |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2016-11-28 |