| NPI | 1619303583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KY ADLAD00223215) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KY 165751) |
| 101YM0800X Counselor Mental Health | |
| 106H00000X Marriage & Family Therapist (Licence: KY 273462) | |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2021-12-15 |