| NPI | 1255792248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 1120028) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: KY 1120028) |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2016-03-17 |