| NPI | 1639714603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY LCSW-1516) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WY PCSW-873) |
| Enumeration Date | 2019-11-13 |
| Last Update Date | 2023-02-27 |