| NPI | 1821345794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 11792) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 11792) |
| 101YP2500X Counselor, Professional (Licence: CO 0017019) | |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2024-07-25 |