| NPI | 1811373079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA 60977364) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR STB-A-101681154) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2022-06-22 |