| NPI | 1164264719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P022526) |
| Enumeration Date | 2024-06-12 |
| Last Update Date | 2026-05-21 |