| NPI | 1578003729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA CG60905961) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG60905961) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA co60717722) | |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2019-02-22 |