| NPI | 1114591773 |
|---|---|
| Former Name | GINA LORI ROY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 255660) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 279337) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2024-04-09 |