| NPI | 1619279171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: KY 1511) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: KY LPCA 0344) |
| Enumeration Date | 2010-12-03 |
| Last Update Date | 2014-06-16 |