| NPI | 1487290490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA MC61489438) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CO61540610) |
| 106S00000X Behavior Technician (Licence: WA CB60980940) | |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2024-04-08 |