| NPI | 1821520701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 269465) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 246759) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 172773) | |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2023-08-17 |