| NPI | 1154472991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG60150302) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA RC00004212) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2011-03-15 |