| NPI | 1962917526 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60662707) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC61308087) |
| 171M00000X Case Manager/Care Coordinator (Licence: WA CP60662707) | |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2024-10-16 |