| NPI | 1023245149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP 60028073) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA RC 00045557) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2009-06-16 |