| NPI | 1407535701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 0018363) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 14129) |
| 101YP2500X Counselor, Professional (Licence: TX 78307) | |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2024-05-15 |