| NPI | 1508469081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 8315) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 23679) |
| Enumeration Date | 2020-11-18 |
| Last Update Date | 2020-11-18 |