| NPI | 1225189764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 16012) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 7317) |
| 101YP2500X Counselor, Professional (Licence: IL 180002879) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2011-06-27 |