| NPI | 1992112668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA CG60684384) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: WA MA60442144) |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2018-04-11 |