| NPI | 1568834372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 166828) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY LPCCCA00222153) |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2016-05-27 |