| NPI | 1053474858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CP00002509) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA CG60134335) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2016-12-15 |