| NPI | 1619344371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 72387) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 32475) |
| 101YM0800X Counselor, Mental Health (Licence: MD LGP5607) | |
| 101YM0800X Counselor, Mental Health (Licence: TX 72387) | |
| 101YP2500X Counselor, Professional (Licence: MD LGP5607) | |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2020-02-22 |