| NPI | 1740739317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WY LPC-1937) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional (Licence: CO LPC.0016540) | |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2021-05-03 |