| NPI | 1104507409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA CAAR.CG.61467574) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: WA CPSS.PR.70103114) |
| Enumeration Date | 2023-07-28 |
| Last Update Date | 2026-03-05 |