| NPI | 1972930790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60366272) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG60508273) |
| Enumeration Date | 2013-10-11 |
| Last Update Date | 2014-10-07 |