| NPI | 1861867830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: KY LPCCCA00222614) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY LPCCCA00222614) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KY LPCCCA00222614) | |
| 101YP2500X Counselor Professional (Licence: KY LPCCCA00222614) | |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2024-03-08 |