| NPI | 1043075336 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 76309) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 13764) | 
| Enumeration Date | 2024-02-16 | 
| Last Update Date | 2024-02-16 |