| NPI | 1316383896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 118338) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY LCSW00001121) |
| 1041C0700X Social Worker, Clinical (Licence: IN 34012479A) | |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2026-07-13 |