| NPI | 1154786572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: KY 273048) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: KY 165436) |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2022-06-09 |