| NPI | 1700965506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: KY 1841) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 1008) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2010-05-24 |