| NPI | 1376078246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AK 4155) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG 60714499) |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2019-07-25 |