| NPI | 1144785692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2020-03-02 |