| NPI | 1972379469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TX 89113) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 59150) |
| 101YP2500X Counselor Professional (Licence: TX 891113) | |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2023-11-27 |