| NPI | 1679172985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 16320) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2024-08-26 |