| NPI | 1508418336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YS0200X Counselor School (Licence: TX 1443726) |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2019-07-11 |