| NPI | 1912163775 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60335668) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60702754) | 
| 101YM0800X Counselor, Mental Health (Licence: WA MC 60186320) | |
| Enumeration Date | 2008-07-31 | 
| Last Update Date | 2019-08-22 |