| NPI | 1780769216 |
|---|---|
| Former Name | LYNETTE EFFIE NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP00005446) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA LW 60363996) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2013-06-10 |