| NPI | 1083107361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 11209) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 11209) |
| 101YP2500X Counselor, Professional (Licence: TX 79318) | |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2022-02-04 |