| NPI | 1588056600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 251273) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KY 11-19) |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2019-10-30 |