| NPI | 1679835847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 257160) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 257160) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2023-06-18 |