| NPI | 1790359115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA MG61372446) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO61511180) |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2024-09-19 |