| NPI | 1700295060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA FC00000212) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CL60156804) |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2014-08-11 |