NPI | 1356696884 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA SC 60205492) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP 60214478) |
Enumeration Date | 2012-07-20 |
Last Update Date | 2016-05-04 |