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 |