| NPI | 1073998712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 70206) |
| Additional Taxonomies | 101YS0200X Counselor School (Licence: TX 06/30/2017) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 28357) | |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2021-08-17 |