NPI | 1316661424 |
---|---|
Former Name | ALICIA RYALS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 69424) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 16124) |
Enumeration Date | 2022-10-03 |
Last Update Date | 2024-08-03 |