| NPI | 1245351261 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 66098)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 11318)  | 
| Enumeration Date | 2007-04-03 | 
| Last Update Date | 2011-09-13 |