| NPI | 1215364237 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60400350) | 
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: WA CG60210325) | 
| Enumeration Date | 2013-10-04 | 
| Last Update Date | 2014-02-04 |