| NPI | 1861482713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 8941) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: HI 1184-03) |
| 101YP2500X Counselor, Professional (Licence: TX 16580) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2007-07-08 |