| NPI | 1568757003 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY 1299)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WY PPC-584)  | 
| Enumeration Date | 2011-06-13 | 
| Last Update Date | 2015-11-24 |