| NPI | 1952401598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WY LPC-2122) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY LPC-2122) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WY PPC-1234) | |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2024-03-08 |