| NPI | 1447562350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: RI MHC00614) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MA 8251) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2014-04-09 |