| NPI | 1962524603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY LPC-1008) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 4264) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2023-03-14 |