| NPI | 1114618337 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health | 
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator | 
| 172V00000X Community Health Worker | |
| Enumeration Date | 2023-05-18 | 
| Last Update Date | 2023-06-29 |