| NPI | 1053572941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: GA RN100589) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2008-06-23 |