| NPI | 1609494830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG61177156) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2021-06-01 |