NPI | 1013446194 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL MH20160) |
Enumeration Date | 2017-06-12 |
Last Update Date | 2024-11-20 |