NPI | 1346697562 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NY 473799-1) |
Enumeration Date | 2016-05-17 |
Last Update Date | 2016-05-17 |