| NPI | 1942858816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO61001779) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA SC60971181) |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2019-09-18 |