| NPI | 1063741510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 2508) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2009-12-11 |
| Last Update Date | 2010-02-03 |