| NPI | 1982998803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 1570) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH C. 0600446) |
| 101YM0800X Counselor, Mental Health (Licence: KY 1570) | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2016-02-29 |