| NPI | 1013074954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WA LW60127918) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CP60106906) |
| 104100000X Social Worker (Licence: WA LW60127918) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2014-08-11 |