| NPI | 1811056674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CP00005533) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA LH00004887) |
| 101YP2500X Counselor Professional (Licence: VA 85353 MAC,NAADAC) | |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2007-07-08 |