| NPI | 1063816411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WY LPC-1505) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO LPC00018795) |
| 101YP2500X Counselor Professional (Licence: WY 1505) | |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2025-03-04 |