NPI | 1043047780 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
Additional Taxonomies | 251S00000X |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2024-09-17 |
Last Update Date | 2024-09-26 |