| NPI | 1750758660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 15776) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2021-06-10 |