| NPI | 1992991376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172M00000X Mechanotherapist (Licence: WA MA00020835) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60941313) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2021-02-19 |