| NPI | 1962967190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180012929) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 78662) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 14333) | |
| 101YP2500X Counselor, Professional (Licence: TX 78662) | |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2021-12-14 |