| NPI | 1639356306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: WY 470) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WY LPC-876) |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2009-11-03 |