| NPI | 1386611168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 9513) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA 30943) |
| 103T00000X Psychologist (Licence: TX 30943) | |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2022-07-21 |