| NPI | 1588702104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA RC00012256) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CP00000624) |
| Enumeration Date | 2007-02-03 |
| Last Update Date | 2008-01-17 |