| NPI | 1760019566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA MC61140763) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG61019299) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60771150) | |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2021-09-14 |