| NPI | 1699055624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH61023501) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60591558) |
| 171000000X Military Health Care Provider | |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2024-04-05 |