| NPI | 1083997886 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 104439)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY 1320)  | 
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2011-09-28 | 
| Last Update Date | 2018-03-17 |