| NPI | 1912604166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 61414893) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2023-02-08 |
| Last Update Date | 2024-06-27 |