| NPI | 1346399797 |
|---|---|
| Former Name | STACEY MAUREEN LAVES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 6327) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 10993) |
| 106H00000X Marriage & Family Therapist (Licence: TX 003603) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2007-07-08 |