| NPI | 1386925576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY 556) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WY LPC - 1321) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2013-01-11 |