| NPI | 1619134764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 5001) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TN 5239) |
| 106H00000X Marriage & Family Therapist (Licence: KY 0853) | |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2019-01-18 |