| NPI | 1972622983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA LH00003623) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CP00002691) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2009-01-30 |