| NPI | 1417340571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 172763) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 349091) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 165186) | |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2017-05-11 |