| NPI | 1558636910 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH1119165) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60198504) | 
| Enumeration Date | 2012-03-19 | 
| Last Update Date | 2021-04-10 |