| NPI | 1013451863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TS0200X Psychologist School (Licence: WY PTSB70891) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WY PPC-953) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2019-12-26 |