NPI | 1912476540 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: TX 37185) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12755) |
Enumeration Date | 2018-11-13 |
Last Update Date | 2018-11-13 |