| NPI | 1477092047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WY 708) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY PPC-990) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2024-01-17 |