| NPI | 1285913194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: GA 033924586) |
| Additional Taxonomies | 104100000X Social Worker (Licence: GA 372600000x) |
| 172V00000X Community Health Worker (Licence: GA 033924586) | |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2011-08-09 |