| NPI | 1154890028 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 92811) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60617153) | 
| 101YM0800X Counselor, Mental Health (Licence: WA MC60838690) | |
| Enumeration Date | 2018-11-20 | 
| Last Update Date | 2025-05-27 |