| NPI | 1972231025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO61413292) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA61136802) |
| Enumeration Date | 2022-08-08 |
| Last Update Date | 2024-07-03 |