| NPI | 1245810779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 259598) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 278592) |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2026-04-06 |