| NPI | 1659893766 |
|---|---|
| Former Name | CAROLYN JEAN BURLESON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 75008) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 13108) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2023-09-22 |