| NPI | 1962767319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY LCSW-937) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY 506) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2016-01-14 |