| NPI | 1073926382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY PPC-1508) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IA 001403) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2025-08-26 |