| NPI | 1477045565 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 202017) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12907) | 
| 101YP2500X Counselor, Professional (Licence: TX 74086) | |
| Enumeration Date | 2018-06-04 | 
| Last Update Date | 2019-06-11 |