| NPI | 1376150276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner (Licence: KY 0135) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: KY 0135) |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2020-09-25 |