| NPI | 1326418153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WY LCSW - 708) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY LCSW - 708) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WY LCSW - 708) | |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2021-08-26 |