NPI | 1912265950 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 252027) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KY 173647) |
Enumeration Date | 2012-04-27 |
Last Update Date | 2018-03-17 |