| NPI | 1871148882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA MC61042060) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1864) |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2020-03-26 |