| NPI | 1912158536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 261610) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2020-02-18 |