| NPI | 1407176613 |
|---|---|
| Former Name | AMANDA JEAN DISHON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KY 2013-003) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KY 6241) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2013-11-18 |