| NPI | 1548807175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO61021630) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149041558) |
| Enumeration Date | 2019-12-02 |
| Last Update Date | 2026-08-18 |