| NPI | 1487297008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 79136) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: TX 1018-0319) |
| Enumeration Date | 2019-10-27 |
| Last Update Date | 2023-12-01 |