| NPI | 1811588114 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 91018) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 15461) | 
| Enumeration Date | 2021-01-29 | 
| Last Update Date | 2023-03-02 |