| NPI | 1629759394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: WA CB61568545) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 61456404) |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2024-10-23 |