| NPI | 1952678831 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW 60085787) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP 00001326) | 
| Enumeration Date | 2011-11-21 | 
| Last Update Date | 2011-11-21 |