| NPI | 1609940170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 423) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH 1-0005580) |
| 106H00000X Marriage & Family Therapist (Licence: KY 0382) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2009-10-29 |