| NPI | 1992240212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA LF61367549) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA 911189908) |
| Enumeration Date | 2016-12-21 |
| Last Update Date | 2023-01-05 |