| NPI | 1104209154 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 172V00000X Community Health Worker | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 103T00000X Psychologist | |
| Enumeration Date | 2015-07-08 | 
| Last Update Date | 2019-06-18 |