| NPI | 1215587621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA CG61001787) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG61001787) |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2020-01-29 |