| NPI | 1205054970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 105702) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 0557) |
| 101YM0800X Counselor, Mental Health (Licence: KY 1200) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 165995) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2016-09-12 |