| NPI | 1194186320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WY LPC-2169) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY PPC-1219) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WY CAP-161) | |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2023-04-25 |