| NPI | 1295090249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: 5945) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: CO 5945) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2023-11-09 |