| NPI | 1619924578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 104216) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 0105) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2024-02-06 |