| NPI | 1972987741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 10674) |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit (Licence: TX 3883-4817) |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: TX 3883-4817) | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: TX 3883-4817) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 3883-4817) | |
| Enumeration Date | 2015-07-11 |
| Last Update Date | 2024-09-25 |