| NPI | 1912563016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA LH61174165) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA MC60965330) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA CG60966735) | |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2021-09-10 |