| NPI | 1104254507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY LCSW00001057) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KY 257661) |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2025-07-18 |