| NPI | 1811555659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 247384) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 274937) |
| 106H00000X Marriage & Family Therapist (Licence: KY 275036) | |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2022-01-09 |