| NPI | 1619766110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 300610) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 295399) |
| Enumeration Date | 2025-05-02 |
| Last Update Date | 2025-07-21 |