| NPI | 1245821230 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 83934) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 15260) | 
| Enumeration Date | 2021-02-01 | 
| Last Update Date | 2024-10-08 |