| NPI | 1972587319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY 910) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WY 910) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2009-06-30 |