| NPI | 1639619869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60246204) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2025-08-27 |