| NPI | 1841666245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 83508) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 0012564) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 0007021) | |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2024-01-19 |