| NPI | 1912673195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 61144262) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 61523203) |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2025-03-20 |