| NPI | 1619472453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 269548) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 240547) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2021-03-31 |