| NPI | 1770350969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG61688711) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO61325888) |
| Enumeration Date | 2023-12-07 |
| Last Update Date | 2025-07-22 |