| NPI | 1700345832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 61474) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 13693) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 61474) | |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2023-10-26 |