| NPI | 1952667933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA LH00009490) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CP00005967) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2012-04-04 |