| NPI | 1013655760 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP61656038)  | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA 61229019)  | 
| Enumeration Date | 2022-05-23 | 
| Last Update Date | 2025-05-19 |