| NPI | 1972931525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 279205) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY KY-1604) |
| Enumeration Date | 2013-10-17 |
| Last Update Date | 2023-02-06 |