| NPI | 1467874396 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MA 1467874396) | 
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: MA 1467874396) | 
| 251B00000X Case Management | |
| Enumeration Date | 2014-01-13 | 
| Last Update Date | 2014-12-10 |