| NPI | 1396823555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY LPC- 677) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ CC 1278) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2011-07-11 |