| NPI | 1265104012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 257296) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 254909) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 279096) | |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2023-08-28 |