| NPI | 1467627174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 00006079) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: WA DE00001401) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2018-12-20 |