| NPI | 1265960736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 164W00000X Licensed Practical Nurse (Licence: LA 20102587) | |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2019-06-27 |