| NPI | 1174637730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: KY 270486) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: KY 0371) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2021-08-04 |