| NPI | 1366985335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2016-11-23 |