| NPI | 1902294523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 163516) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 00218624) |
| 101YM0800X Counselor, Mental Health (Licence: KY 1512) | |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2020-04-23 |