| NPI | 1124486873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60534472) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC60641016) |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2018-09-04 |