| NPI | 1841740446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX 75279) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 13223) |
| 101YM0800X Counselor, Mental Health (Licence: TX 75279) | |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2021-02-21 |