| NPI | 1649501875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: TX 26919) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 7259) |
| 103TC1900X Psychologist Counseling (Licence: OK MASTER OF HUMAN RELA) | |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2010-09-16 |