| NPI | 1861709834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 3786) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 0660) |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2015-11-13 |