| NPI | 1790814606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 3352) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KY 0759) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2011-05-05 |