| NPI | 1003464355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60979141) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA 60979141) |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2019-11-21 |