| NPI | 1972611713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 6404) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 10158) |
| 106H00000X Marriage & Family Therapist (Licence: TX 004405-040806) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2007-07-09 |