| NPI | 1972240398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: WY 25942) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WY LPC-1121) |
| Enumeration Date | 2022-05-17 |
| Last Update Date | 2022-09-27 |