NPI | 1639765233 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY LPC-2303) |
Additional Taxonomies | 101Y00000X Counselor (Licence: WY PPC-1290) |
101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-79740) | |
Enumeration Date | 2020-12-17 |
Last Update Date | 2025-08-19 |