| NPI | 1518629104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WY LPC-2053) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WY LPC-2053) |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2021-10-11 |
| Last Update Date | 2022-06-17 |