| NPI | 1245578020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA CP60256603) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: WA CP60256603) |
| Enumeration Date | 2013-01-29 |
| Last Update Date | 2021-08-19 |