| NPI | 1902131352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WY LPC-1293) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WY LPC-1293) |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2018-08-30 |