| NPI | 1619019882 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KY 105305)  | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KY 887)  | 
| 106H00000X Marriage & Family Therapist (Licence: KY 2012-018)  | |
| Enumeration Date | 2007-02-13 | 
| Last Update Date | 2017-02-13 |