| NPI | 1528484458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 252462) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY CSW-6148) |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2017-02-01 |