| NPI | 1851707574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WY 983) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY PCSW-583) |
| 1041C0700X Social Worker, Clinical (Licence: WY LCSW-983) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2021-05-19 |