| NPI | 1255055323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2024-01-25 |