| NPI | 1588080477 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: 68600) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12072) | 
| 106H00000X Marriage & Family Therapist (Licence: TX 201782) | |
| Enumeration Date | 2014-03-15 | 
| Last Update Date | 2015-05-27 |