| NPI | 1154475994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA LH00003771) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP00000475) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2013-12-13 |