| NPI | 1396960480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WY LPC-757) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 7693559-6004) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2010-12-03 |