| NPI | 1003939653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 1740) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 1740) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 0373) | |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-10-23 |