| NPI | 1740826502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA MC61130115) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CO60988213) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: WA CO60988213) | |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2023-03-10 |