| NPI | 1376965293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WY LPC-1784) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO NLC.0013065) |
| Enumeration Date | 2014-01-12 |
| Last Update Date | 2021-10-04 |