| NPI | 1265052153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 281989) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KY 289940) |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2024-01-30 |