| NPI | 1962912105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WA SC60879140) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CO60877922) |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2019-01-03 |