| NPI | 1114048873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA LW60524212) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: WA LW60524212) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2023-12-15 |