| NPI | 1215492509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 79839) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 13853) |
| 101YM0800X Counselor, Mental Health (Licence: TX 79839) | |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2022-11-01 |