| NPI | 1639181860 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 4095) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 11631) | 
| Enumeration Date | 2006-08-13 | 
| Last Update Date | 2025-09-11 |