| NPI | 1649554288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY LPC - 1002) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY 1002) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2018-10-01 |