| NPI | 1679909725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WY WY-LCSW-936) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WY PCSW-546) |
| Enumeration Date | 2013-09-20 |
| Last Update Date | 2015-11-19 |