| NPI | 1457990285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0733007314) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0732003734) |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 376K00000X Nurse's Aide (Licence: VA 1401096837) | |
| Enumeration Date | 2019-12-26 |
| Last Update Date | 2019-12-26 |