NPI | 1033659560 |
---|---|
Former Name | TRACEY OSBORN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: WA MC60612318) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60633268) |
101YM0800X Counselor, Mental Health (Licence: WA LH60585615) | |
Enumeration Date | 2017-03-02 |
Last Update Date | 2018-03-17 |