| NPI | 1134587314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12045) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 12045) |
| 174400000X Specialist (Licence: TX 12045) | |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2020-04-15 |