| NPI | 1164821476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WY LPC-1551) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY PPC-851) |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2023-02-10 |