NPI | 1366111387 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I-2002050-SUPV) |
Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: OH 1270727) |
Enumeration Date | 2021-09-13 |
Last Update Date | 2022-04-07 |