| NPI | 1033495981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA CG 60244136) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CO 60163702) |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2011-10-24 |