| NPI | 1205265444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY KY 3859) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KY KY-5421) |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2014-02-03 |