| NPI | 1245662857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: KY 5018) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 6354) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2015-09-11 |