| NPI | 1417259169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY LPC-1143) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WY LPC-1143) |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2012-09-11 |