| NPI | 1225673148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 61215211) |
| Additional Taxonomies | 225800000X Recreation Therapist |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2021-10-20 |