| NPI | 1376934869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 252558) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 4626) |
| Enumeration Date | 2015-02-05 |
| Last Update Date | 2017-06-06 |