| NPI | 1942962717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 66355) |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health (Licence: TX 66355) |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: TX 66355) | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: TX 66355) | |
| 3104A0625X Assisted Living Facility Assisted Living, Mental Illness | |
| 101YM0800X Counselor Mental Health (Licence: TX 66355) | |
| 171M00000X Case Manager/Care Coordinator (Licence: TX 66355) | |
| 251B00000X Case Management (Licence: TX 66355) | |
| 251S00000X Community/Behavioral Health (Licence: TX 66355) | |
| 3104A0625X Assisted Living Facility Assisted Living, Mental Illness (Licence: TX 66355) | |
| 310500000X Intermediate Care Facility, Mental Illness (Licence: TX 66355) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: TX 66355) | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: TX 66355) | |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: TX 66355) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: TX 66355) | |
| Enumeration Date | 2021-10-09 |
| Last Update Date | 2021-10-09 |