| NPI | 1912740655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY LPC-2530) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WY PPC1459) |
| Enumeration Date | 2024-06-18 |
| Last Update Date | 2026-03-02 |