| NPI | 1225754922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX INTERN) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 81041) |
| 101YM0800X Counselor Mental Health (Licence: TX 99658) | |
| Enumeration Date | 2022-10-13 |
| Last Update Date | 2023-04-02 |