| NPI | 1881923076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY LAT-328) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY WYPAT038) |
| 101YM0800X Counselor, Mental Health (Licence: WY WYPAT038) | |
| Enumeration Date | 2009-12-17 |
| Last Update Date | 2013-07-02 |