| NPI | 1942621396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 171396) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 1746) |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2017-01-05 |