| NPI | 1679803654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY LPC-1238) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WY PPC505) |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2016-10-28 |