| NPI | 1932683869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY CAP-169) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY PPC-1202) |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2020-11-05 |