| NPI | 1316067945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 5426) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TX 10066) |
| 106H00000X Marriage & Family Therapist (Licence: TX 2904) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2007-07-08 |