| NPI | 1033466917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA LH61219035) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 15859-131) |
| 101YP2500X Counselor Professional (Licence: WI 1686-226) | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 16675-130) | |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2022-02-08 |