| NPI | 1558862573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA CG60754491) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA CG60754491) |
| Enumeration Date | 2018-02-25 |
| Last Update Date | 2018-02-25 |