| NPI | 1053649988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: KY 105803) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KY 106480) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KY 166848) | |
| Enumeration Date | 2009-12-04 |
| Last Update Date | 2016-07-20 |