| NPI | 1952765612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 3466) |
| 106H00000X Marriage & Family Therapist (Licence: KY 105270) | |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2026-08-11 |