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 |