| NPI | 1467569434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 3226) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 4249) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2018-12-07 |