| NPI | 1104043991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 1063) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 1063) |
| 101YM0800X Counselor, Mental Health (Licence: KY KY-1063) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2020-12-02 |