| NPI | 1902177801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WY 1378) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY PPC-631) |
| Enumeration Date | 2012-01-24 |
| Last Update Date | 2024-02-28 |