| NPI | 1619218708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY LPC-796) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY LPC-1448) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY LAT-332) | |
| 101YP2500X Counselor, Professional (Licence: WY LPC-796) | |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2022-07-21 |