| NPI | 1144675836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MI 4704152171) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: MI 4704152171) |
| Enumeration Date | 2016-04-30 |
| Last Update Date | 2016-04-30 |