| NPI | 1669657011 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KY 0754) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KY 106833) |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2024-05-15 |