NPI | 1124675954 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 65241) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 13994) |
101YM0800X Counselor, Mental Health (Licence: TX 65241) | |
Enumeration Date | 2019-08-26 |
Last Update Date | 2023-11-08 |