| NPI | 1407419096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: CMS) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: QMHS) |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: OH 2025) | |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2025-02-28 |