| NPI | 1609180561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY LCSW-919) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2015-02-05 |