| NPI | 1205373107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WY 1359) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY 352) |
| 171100000X Acupuncturist (Licence: WY A-030) | |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2023-04-06 |