| NPI | 1043749310 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK 21219) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2024-10-08 |