| NPI | 1174947592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: DC 40139) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DC 40139) |
| 163W00000X Registered Nurse (Licence: DC 40139) | |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2014-02-05 |