NPI | 1386973725 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
Additional Taxonomies | 101Y00000X Counselor |
101YM0800X Counselor, Mental Health | |
320800000X Community Based Residential Treatment Facility, Mental Illness | |
Enumeration Date | 2009-12-14 |
Last Update Date | 2009-12-14 |