| NPI | 1578836805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WY LPC-1423) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CO LPC.0018586) |
| 101Y00000X Counselor (Licence: WY PPC-614) | |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2023-06-15 |