| NPI | 1922513076 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: WA CO60650873)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60905969)  | 
| 101YM0800X Counselor, Mental Health (Licence: WA LH6091224)  | |
| Enumeration Date | 2017-12-12 | 
| Last Update Date | 2022-05-23 |