| NPI | 1124476874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: WA 602813810) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2019-08-12 |