| NPI | 1174988570 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: LA 6483)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 6483)  | 
| Enumeration Date | 2015-12-30 | 
| Last Update Date | 2018-07-16 |