| NPI | 1790126027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60452845) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C3248) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2016-04-04 |