| NPI | 1619238870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 76270) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WY LPC-1331) |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2019-01-18 |