| NPI | 1356825087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 16251) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TX 215337) |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2023-06-22 |