| NPI | 1407212913 |
|---|---|
| Former Name | SUSAN ELIZABETH BAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 134300) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-13 |