| NPI | 1235674748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA PLC7663) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: LA PLC7663) | |
| Enumeration Date | 2016-12-20 |
| Last Update Date | 2023-07-18 |