| NPI | 1770033706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1005098) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 13673) |
| 101YM0800X Counselor, Mental Health (Licence: TX 78769) | |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2023-12-18 |