| NPI | 1245506500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK 4059) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: OK 4059) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2022-01-04 |