| NPI | 1679047922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WY LPC-1948) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WY PPC-1148) |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2022-01-25 |