| NPI | 1538474630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 3727) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KY 5819) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2013-01-16 |