| NPI | 1063033132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: KY 290301) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 290995) |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2026-04-19 |