| NPI | 1104231836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 60513121) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MC61372103) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2024-12-29 |