| NPI | 1770612327 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 0422) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: KY 92325) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2011-05-16 |