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 |