| NPI | 1477903631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 69795) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12184) |
| 101YM0800X Counselor, Mental Health (Licence: TX 69795) | |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2019-01-08 |