| NPI | 1962592402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: TX 62456) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12532) |
| 101YP2500X Counselor, Professional (Licence: TX 72729) | |
| 106H00000X Marriage & Family Therapist (Licence: TX 202430) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-04-10 |