| NPI | 1760775829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 256183) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 251606) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 0970) | |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2022-01-24 |