| NPI | 1124625520 |
|---|---|
| Former Name | JENNIFER IRLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 10524) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 90488) |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2023-06-30 |