| NPI | 1154178408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC70041059) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: WA CB61261538) |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2025-09-22 |