| NPI | 1679989826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 19392) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 19392) |
| 101YM0800X Counselor, Mental Health (Licence: TX 19392) | |
| 101YM0800X Counselor, Mental Health (Licence: ME CC3436) | |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2014-07-09 |