| NPI | 1134712870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TX 81072) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 15541) |
| Enumeration Date | 2021-02-13 |
| Last Update Date | 2023-10-07 |