| NPI | 1588788822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY LPC-225) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WY LPC-225) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2011-04-19 |