| NPI | 1740746122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 254236) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 252234) |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2019-09-04 |