| NPI | 1043754658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 73255) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12908) |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2016-12-15 |