| NPI | 1184903973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 11327) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 67678) |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2011-08-10 |