| NPI | 1487130092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY CAP-209) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY CAP-209) |
| 101Y00000X Counselor (Licence: WY 1557) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2025-07-03 |