| NPI | 1235678160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 254460) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 254460) |
| 101YM0800X Counselor, Mental Health (Licence: KY 252141) | |
| Enumeration Date | 2017-02-12 |
| Last Update Date | 2020-08-31 |