NPI | 1215490479 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WA MG61153497) |
Enumeration Date | 2019-04-12 |
Last Update Date | 2021-08-17 |