| NPI | 1104175686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY LPC-1840) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 0012319) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2020-03-03 |