| NPI | 1669906624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA SUDPCP61001229) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 6064916) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2025-10-30 |