| NPI | 1669843710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 118429) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KY 298308) |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2025-10-20 |