| NPI | 1073721924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 54495) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 54495) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 9454) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2019-11-13 |