| NPI | 1104161397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60235024) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC60253074) |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2012-11-29 |