| NPI | 1750146791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA 61442071) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: WA LW00005921) |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2024-02-19 |