| NPI | 1295275550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KS 2720) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 398) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 229) | |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2019-03-27 |