| NPI | 1407571797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 297041) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY LCSW00001723) |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2026-09-17 |