| NPI | 1467788851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 3685) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KY 0806) |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2012-09-04 |