| NPI | 1396185583 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH 60557230) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 11842) | 
| 101YP2500X Counselor, Professional (Licence: TX 65631) | |
| Enumeration Date | 2013-07-02 | 
| Last Update Date | 2022-06-22 |