| NPI | 1952751828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA MC61455478) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA61206532) |
| 106S00000X Behavior Technician (Licence: WA CG60674351) | |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2023-07-31 |