| NPI | 1386165348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2017-06-29 |