| NPI | 1619041324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY LPC820) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WY NCC90000) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2007-07-08 |