NPI | 1073667622 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: AL 1592C) |
Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: AL 1592C) |
Enumeration Date | 2007-01-22 |
Last Update Date | 2007-07-09 |