| NPI | 1184162299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 252502) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 168699) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2020-02-28 |