| NPI | 1497995492 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC60143386) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60129769) | 
| Enumeration Date | 2009-03-03 | 
| Last Update Date | 2011-01-10 |