| NPI | 1366208506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: MI AS820417482) |
| Enumeration Date | 2024-02-26 |
| Last Update Date | 2024-02-26 |