| NPI | 1598147365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 241003) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY LPCCCA00218281) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2021-08-10 |