| NPI | 1700440294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA LH61308781) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CO60980465) | |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2022-08-09 |