| NPI | 1871683136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 4194) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 11302) |
| 106H00000X Marriage & Family Therapist (Licence: TX 2765) | |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2007-07-08 |