| NPI | 1164130803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: KY 255348) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KY 271571) |
| Enumeration Date | 2022-11-11 |
| Last Update Date | 2022-12-07 |