| NPI | 1548342041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 1611125) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 042352) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 2247) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2009-07-01 |