| NPI | 1417252958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO61062317) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA60090682) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2021-09-01 |