| NPI | 1124768502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 171400000X Health & Wellness Coach | |
| 251B00000X Case Management | |
| 251S00000X | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QF0050X Clinic/Center, Family Planning, Non-Surgical | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2022-03-31 |