| NPI | 1386280865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 14292) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 79719) |
| 163W00000X Registered Nurse (Licence: TX 629934) | |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2019-12-03 |