| NPI | 1790887701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX SO8078) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX ICRC21155) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX CADACII#121) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2008-04-20 |