| NPI | 1811255854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 6810) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KY 2014-007) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2018-03-17 |