| NPI | 1083143556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA 60456236) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA 60459915) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2017-06-08 |