| NPI | 1770560401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: KY KY-0488) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY KY-1002) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2014-09-15 |