| NPI | 1215415401 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: WA SC61550823) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA SC61550823) |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2024-04-25 |