| NPI | 1194356105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CG61205355) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60844652) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2023-10-11 |