| NPI | 1063876142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 241533) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 241533) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2021-03-10 |