| NPI | 1508103466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 11403) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 67849) |
| Enumeration Date | 2013-01-12 |
| Last Update Date | 2019-10-11 |