| NPI | 1093108391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253J00000X Foster Care Agency (Licence: FL ISW2932) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL ISW2932) |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2015-03-10 |