| NPI | 1013207471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: KY 2015168) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 0211) |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2011-04-19 |