| NPI | 1831573757 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: TX 68080) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 11507) | 
| 101YP2500X Counselor, Professional (Licence: TX 68080) | |
| Enumeration Date | 2015-07-10 | 
| Last Update Date | 2022-08-11 |