| NPI | 1881975563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: KS 2467) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: KS LPC2276) |
| 1041C0700X Social Worker Clinical (Licence: KS 2467) | |
| Enumeration Date | 2011-09-08 |
| Last Update Date | 2021-10-22 |