| NPI | 1215205190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WY 1231) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: WY CERTIFICATION) |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2011-12-07 |