| NPI | 1063281012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 16724) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TX 91261) |
| Enumeration Date | 2024-01-01 |
| Last Update Date | 2024-06-05 |