| NPI | 1174085658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP00002099) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60172456) |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2019-04-03 |