| NPI | 1508499799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 104865) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 2524-6140) |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2020-02-17 |