| NPI | 1891211066 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 104100000X Social Worker (Licence: TX 63951)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 27274)  | 
| 103T00000X Psychologist (Licence: TX 40905)  | |
| Enumeration Date | 2017-08-18 | 
| Last Update Date | 2025-10-09 |