| NPI | 1649852302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: GA LPC015880) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY LPC-2266) |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2025-09-26 |