| 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 |