| NPI | 1750612123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP61042964) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH00069477) |
| Enumeration Date | 2010-01-24 |
| Last Update Date | 2024-01-16 |