| NPI | 1912580507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 15606) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 104276) |
| Enumeration Date | 2021-04-30 |
| Last Update Date | 2021-04-30 |