| NPI | 1255698882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY LPC1379) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY PPC-657) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2024-01-11 |