NPI | 1356678114 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX LPC - S 11840) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX LCDC - 686) |
Enumeration Date | 2009-11-14 |
Last Update Date | 2009-11-14 |