| NPI | 1669015152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 61028914) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: WA 60783153) |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2021-04-15 |