| NPI | 1366718157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 26644) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 26644) |
| 101YM0800X Counselor, Mental Health (Licence: TX 26644) | |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2023-01-24 |