| NPI | 1528366275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 267764) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY 2011-02) |
| Enumeration Date | 2011-03-04 |
| Last Update Date | 2023-06-15 |