| NPI | 1700331519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 244394) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 168213) |
| 101YM0800X Counselor, Mental Health (Licence: KY 168213) | |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2020-11-09 |