| NPI | 1962921411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: WA CO60717035) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2022-07-21 |