| NPI | 1396079067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 07284) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 1264-1000) |
| 101YP2500X Counselor, Professional (Licence: TX 1165) | |
| 106H00000X Marriage & Family Therapist (Licence: TX 2191) | |
| Enumeration Date | 2009-09-28 |
| Last Update Date | 2011-05-31 |