| NPI | 1104213065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 255152) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 337949) |
| 1041C0700X Social Worker, Clinical (Licence: KY 3478) | |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2024-09-16 |