| NPI | 1821868118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 4607) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 3948) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 3690) | |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2024-01-08 |