| NPI | 1194217448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 126900000X Dental Laboratory Technician |
| 132700000X Dietary Manager | |
| 146L00000X Emergency Medical Technician, Paramedic | |
| 293D00000X Physiological Laboratory | |
| Enumeration Date | 2018-06-02 |
| Last Update Date | 2018-06-02 |