| NPI | 1710361456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 174350) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY LPCCCA00216594) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2018-06-27 |