| NPI | 1467823013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CP 60202854) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG 60527202) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP 60202854) | |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2016-02-16 |