| NPI | 1548638570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 173969) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 1332) |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2022-07-21 |