| NPI | 1780965798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA MC60180917) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CO60145856) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2011-09-02 |