| NPI | 1083020226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 252363) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 168416) |
| 104100000X Social Worker (Licence: KY 6999) | |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2019-07-08 |