| NPI | 1174894018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WY LPC-1261) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WY 1261) |
| 101Y00000X Counselor (Licence: WY 1261) | |
| Enumeration Date | 2012-01-24 |
| Last Update Date | 2018-08-21 |