| NPI | 1417315060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY LAT-380) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY PPC-992) |
| 101YP2500X Counselor, Professional (Licence: WY LPC-1888) | |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2021-09-02 |