| NPI | 1770082885 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: TX 76033) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 76033) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 76033) | |
| 101YM0800X Counselor, Mental Health (Licence: TX 76033) | |
| 101YP2500X Counselor, Professional (Licence: TX 76033) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: TX 76033) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: TX 76033) | |
| 251S00000X (Licence: TX 76033) | |
| Enumeration Date | 2018-02-04 |
| Last Update Date | 2018-02-04 |