| NPI | 1396283081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY PPC-1027) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY CAP-163) |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2017-10-20 |