| NPI | 1851809388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WY LPC-1899) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY PPC-1048) |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2020-11-05 |