| NPI | 1306266820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 104127) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 1671) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2022-06-15 |