| NPI | 1629400080 |
|---|---|
| Former Name | GLADYS JUDITH PENA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 71597) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 11952) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2020-08-26 |