| NPI | 1114684586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 266724) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 255715) |
| Enumeration Date | 2021-11-20 |
| Last Update Date | 2025-01-01 |