| NPI | 1548251606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY LPC 487) |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: WY 12328.719) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2007-07-08 |