| NPI | 1205550779 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 89740) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12743) | 
| 101YM0800X Counselor, Mental Health (Licence: TX 89740) | |
| Enumeration Date | 2022-09-28 | 
| Last Update Date | 2024-11-27 |