| NPI | 1588048805 |
|---|---|
| Former Name | SUSAN RUTH CAVANAUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP00000160) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2019-08-30 |