| NPI | 1154788271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 218905-6009) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 218905-6006) |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2020-02-01 |