| NPI | 1114580594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA 101Y00000X-Counselor) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG60328778) |
| Enumeration Date | 2019-04-21 |
| Last Update Date | 2019-04-21 |