| NPI | 1346788650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60820633) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: WA 61033188) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2020-12-14 |