| NPI | 1588012595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY LPC-718) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WY 718) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2016-10-27 |