| NPI | 1174191258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 258582) |
| Additional Taxonomies | 104100000X Social Worker |
| 101YM0800X Counselor, Mental Health (Licence: KY 258582) | |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2025-12-03 |