| NPI | 1063505121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 273R00000X Psychiatric Unit |
| 282N00000X General Acute Care Hospital | |
| 283Q00000X Psychiatric Hospital | |
| 310400000X Assisted Living Facility | |
| 3104A0625X Assisted Living Facility Assisted Living, Mental Illness | |
| 3104A0630X Assisted Living Facility Assisted Living, Behavioral Disturbances | |
| 314000000X Skilled Nursing Facility | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2012-04-12 |