| NPI | 1811982168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 1665) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TX 18089) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2007-07-08 |