| NPI | 1144115205 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| 172V00000X Community Health Worker | |
| 251B00000X Case Management | |
| 174H00000X Health Educator | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2025-06-10 |
| Last Update Date | 2025-06-10 |