| NPI | 1972987741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: TX 3883) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 10674) |
| Enumeration Date | 2015-07-11 |
| Last Update Date | 2019-11-21 |