| NPI | 1407204472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA CO60636606) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA CO60636606) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2016-09-29 |