| NPI | 1407327166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: WA 60969562) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60884647) |
| Enumeration Date | 2018-12-06 |
| Last Update Date | 2019-10-17 |