| NPI | 1649623661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 90645) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710102556) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 17541) | |
| 101YP2500X Counselor, Professional (Licence: VA 0701006697) | |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2026-03-31 |