| NPI | 1174974562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 127690) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 127690) |
| 101YM0800X Counselor, Mental Health (Licence: KY 127690) | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2016-10-27 |