| NPI | 1265986236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WA LW 60628432) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CP 60466662) |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2016-09-23 |