| NPI | 1043710338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KY 175245) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 172920) |
| 101YS0200X Counselor, School (Licence: KY 201195131) | |
| Enumeration Date | 2018-02-13 |
| Last Update Date | 2018-02-13 |