| NPI | 1083424147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 14203) |
| Enumeration Date | 2025-01-10 |
| Last Update Date | 2025-03-06 |