| NPI | 1386050516 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 201860) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12060) | 
| 101YP2500X Counselor, Professional (Licence: TX 69232) | |
| Enumeration Date | 2014-07-09 | 
| Last Update Date | 2014-07-09 |