| NPI | 1891174033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: KY KY-0775) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY KY-0775) |
| 101YP2500X Counselor, Professional (Licence: KY KY-0775) | |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2015-05-20 |