| NPI | 1518673672 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC61297200) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP61283636) | 
| 101YM0800X Counselor, Mental Health (Licence: LA PLC9215) | |
| Enumeration Date | 2023-01-23 | 
| Last Update Date | 2023-06-14 |