NPI | 1093343949 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
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 |