| NPI | 1093343949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 104100000X Social Worker |
| 164W00000X Licensed Practical Nurse (Licence: AL 2-050124) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2022-10-25 |