| NPI | 1336570704 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 11367) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NM CTB-2022-0809) | 
| Enumeration Date | 2013-12-10 | 
| Last Update Date | 2024-05-15 |