| NPI | 1174815401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60382513) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA LH60382513) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA CO60246524) | |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2014-04-09 |