| NPI | 1891104600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 3784) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY KY3784) |
| 1041C0700X Social Worker, Clinical (Licence: OR 24-QMHP-R-2874) | |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2024-06-27 |