| NPI | 1033329222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 1364) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 0001) |
| 101YP2500X Counselor, Professional (Licence: KY 0052) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2014-12-30 |