| NPI | 1851785430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 1301) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 1301) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 0200) | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2015-03-23 |