| NPI | 1114671294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 87953) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 16097) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 53188) | |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2025-01-16 |