| NPI | 1396918728 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 507221-6006) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 5072211-3902) | 
| Enumeration Date | 2008-04-07 | 
| Last Update Date | 2008-04-07 |