| NPI | 1902057664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 11) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OK 1181) |
| 101Y00000X Counselor (Licence: TX 63681) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 10650) | |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2015-12-28 |