| NPI | 1376189399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 14102) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TX 82129) |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2022-02-10 |