| NPI | 1750634838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY CAP-119) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WY LPC-1641) |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2018-07-20 |