| NPI | 1679204135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 61660491) |
| Additional Taxonomies | 101Y00000X Counselor |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2025-10-13 |