| NPI | 1134472954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: KY 1281) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: KY 1281) |
| 103TA0700X Psychologist Adult Development & Aging | |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2012-10-17 |