| NPI | 1407262678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 247200000X Technician, Other |
| 251S00000X | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2021-04-16 |