| NPI | 1922714963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 310505) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 290143) |
| Enumeration Date | 2023-01-24 |
| Last Update Date | 2026-07-19 |