| NPI | 1154696078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60215280) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MG60155430) |
| Enumeration Date | 2012-03-09 |
| Last Update Date | 2012-03-09 |