| NPI | 1144679697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 71819) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12785) |
| 101YP2500X Counselor, Professional (Licence: TN 5351) | |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2026-07-30 |