| NPI | 1710249560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CO60285375) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2021-07-22 |