| NPI | 1982802252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY 191) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WY 681) |
| 106H00000X Marriage & Family Therapist (Licence: WY 94) | |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2007-07-08 |