| NPI | 1619540721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 79251) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 13411) |
| 106H00000X Marriage & Family Therapist (Licence: TX 202991) | |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2021-07-19 |