| NPI | 1992018865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT 1491) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 1157) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY LAT-342) | |
| 101YM0800X Counselor, Mental Health (Licence: WY LPC-1206) | |
| 106H00000X Marriage & Family Therapist (Licence: MT 128) | |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2017-11-14 |