| NPI | 1972926673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 272387) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 168587) |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2021-09-03 |