| NPI | 1073048500 |
|---|---|
| Other Name | NA NA NA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 60840388) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 61106515) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2021-07-06 |