| NPI | 1912461260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 87165) |
| Additional Taxonomies | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: TX 40919) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 16408) | |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2023-09-16 |