| NPI | 1053856021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60688891) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG61104191) |
| Enumeration Date | 2016-12-30 |
| Last Update Date | 2021-07-23 |