| NPI | 1609064831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 167707) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY 128847) |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2024-03-20 |