| NPI | 1124310602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60167585) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG60163848) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2011-05-03 |