| NPI | 1912584533 |
|---|---|
| Former Name | AMANDA GANS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA 60444516) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WA 60444516) |
| Enumeration Date | 2021-03-28 |
| Last Update Date | 2023-06-13 |