| NPI | 1417273269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 253088) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 164999) |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2020-10-27 |