| NPI | 1467619312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 16912) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA B00001750521) |
| 167G00000X Licensed Psychiatric Technician (Licence: CA 42020) | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2024-07-29 |