| NPI | 1205955390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WA CP00004989) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA RC00041017) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2017-12-01 |