| NPI | 1396397014 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 5051)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 168441)  | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 168441)  | |
| 101YP2500X Counselor, Professional (Licence: KY 5051)  | |
| Enumeration Date | 2019-07-12 | 
| Last Update Date | 2021-09-25 |