| NPI | 1689853491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY LPC-1145) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WY LPC-1145) |
| 101YM0800X Counselor Mental Health (Licence: WY LPC-1145) | |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2014-12-13 |