| NPI | 1639676695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WA SC61306204) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA 61147421) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA 11205-I) | |
| 104100000X Social Worker (Licence: WA SC61306204) | |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2022-11-29 |