| NPI | 1356530463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY LPC-1602) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY LPC-1602) |
| 101YM0800X Counselor, Mental Health (Licence: CO LPC-2476) | |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2020-12-14 |