| NPI | 1124479258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 253949) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 7668) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2019-04-15 |