| NPI | 1174740989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 1448) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 0766) |
| 101YM0800X Counselor, Mental Health (Licence: KY 0500) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2014-08-05 |