| NPI | 1942598024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 13748) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS TLMP1393) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2022-01-12 |