| NPI | 1619136405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA MC60113967) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA MC60113967) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2013-09-18 |