| NPI | 1649459058 |
|---|---|
| Former Name | MYCAH ERIN CHRISTIANSEN/DVORAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60176350) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 60900332) |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2019-08-23 |