| NPI | 1730412743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 272556) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 247159) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 245089) | |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2025-02-28 |