NPI | 1306233358 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: UT 5734264-6009) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 5734264-6006) |
Enumeration Date | 2015-04-16 |
Last Update Date | 2015-04-16 |