| NPI | 1962823526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: KY 161948) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: KY 1210) |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2024-05-01 |