| NPI | 1518435759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: KY 243847) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KY 243847) |
| 101YM0800X Counselor Mental Health (Licence: KY 243847) | |
| Enumeration Date | 2018-11-06 |
| Last Update Date | 2019-04-30 |