| NPI | 1245776616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 81755) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 81775) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 14775) | |
| 101YP2500X Counselor, Professional (Licence: TX 81755) | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2020-10-27 |