| NPI | 1750516902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: TX 52473) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 52473) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12058) | |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2014-06-17 |