| NPI | 1225702483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 252954) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 262577) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2024-11-20 |