| NPI | 1578018545 |
|---|---|
| Former Name | ANDREA FREDERICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60906465) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60888603) |
| 1041C0700X Social Worker, Clinical (Licence: WA SC60586938) | |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2022-02-16 |