| NPI | 1457877052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-6406T) |
| Additional Taxonomies | 385H00000X Respite Care (Licence: AZ bh5025) |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2020-04-29 |