| NPI | 1902351141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 92364) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM CAD0192891) |
| 101YP2500X Counselor, Professional (Licence: NM CCMH0225361) | |
| Enumeration Date | 2016-08-17 |
| Last Update Date | 2024-01-31 |