| NPI | 1154411551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 56123) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 9778) |
| 101YP2500X Counselor, Professional (Licence: TX 19646) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-07-08 |