| NPI | 1740618834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 252408) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 1884) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2020-12-23 |