| NPI | 1124515267 |
|---|---|
| Former Name | SUSAN REID |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 60844092) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 60776697) |
| Enumeration Date | 2018-04-14 |
| Last Update Date | 2018-04-14 |