| NPI | 1669801635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WY 1646) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY PPC-786) |
| Enumeration Date | 2013-11-10 |
| Last Update Date | 2017-06-15 |