| NPI | 1215304332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG60596539) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 175T00000X Peer Specialist (Licence: WA CG60596539) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2021-04-12 |