| NPI | 1538689617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 172612) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 172612) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2020-11-03 |