| NPI | 1265888085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OH E.1901168) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2026-03-07 |