| NPI | 1134584527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: OR 15-11-08) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 20-10-06) |
| 101YM0800X Counselor, Mental Health (Licence: OR 21-QMHP-R-0664) | |
| 1041C0700X Social Worker, Clinical (Licence: WA SWIA.SC.61162847) | |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2021-08-31 |