| NPI | 1518288554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 103669) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 1440) |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2023-12-01 |