| NPI | 1265034185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 259778) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 292582) |
| Enumeration Date | 2020-11-16 |
| Last Update Date | 2025-01-31 |