| NPI | 1104342096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 253J00000X Foster Care Agency | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2017-08-22 |