| NPI | 1750775359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TX 82019) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 12666) |
| 101YP2500X Counselor Professional (Licence: TX 82019) | |
| 101Y00000X Counselor (Licence: TX 82019) | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2023-10-23 |