| NPI | 1861563470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 1725) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 5520) |
| 106H00000X Marriage & Family Therapist (Licence: TX 003272-004084) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2007-07-08 |