| NPI | 1063949303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: KY 261185) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 172410) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 170791) | |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2022-05-27 |