| NPI | 1265946859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 256264) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 252443) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2017-11-19 |
| Last Update Date | 2023-10-19 |