| NPI | 1396184925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 2016008416) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: MO 2013018485) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2023-05-11 |