| NPI | 1902620743 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC61583699)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA C061489646)  | 
| Enumeration Date | 2024-11-08 | 
| Last Update Date | 2024-11-08 |