| NPI | 1275905556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC LCSWA P009966) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NC LCAS 22302) |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2015-10-26 |