| NPI | 1679664809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 3971) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 6517) |
| 106H00000X Marriage & Family Therapist (Licence: TX 2641) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2007-07-08 |