| NPI | 1861680597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: KY 268813) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KY 1041) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2021-05-26 |