| NPI | 1043859762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 257753) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 281314) |
| 104100000X Social Worker (Licence: KY 254407) | |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2024-11-08 |