| NPI | 1578965182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CP 00004295) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA MC60323125) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2014-09-25 |