| NPI | 1962895300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 5002) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 6376) |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2018-03-17 |