| NPI | 1497165633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: KY 171522) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: KY 1180) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2017-04-24 |