| NPI | 1235684408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60741726) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: WA CO60237827) |
| Enumeration Date | 2016-08-17 |
| Last Update Date | 2020-08-25 |