| NPI | 1912375940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA MC60894235) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CP18343) |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2019-06-19 |