NPI | 1922200815 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 974) |
Additional Taxonomies | 101Y00000X Counselor (Licence: TX 18524) |
101Y00000X Counselor (Licence: LA 2642) | |
106H00000X Marriage & Family Therapist (Licence: LA 304) | |
Enumeration Date | 2007-06-03 |
Last Update Date | 2019-04-10 |