| NPI | 1770863987 |
|---|---|
| Former Name | CARLY WALKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA LW60834632) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2020-09-14 |