| NPI | 1720319395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 10645) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 62885) |
| Enumeration Date | 2010-01-21 |
| Last Update Date | 2015-01-02 |