| NPI | 1508231671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 5054) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: LA 5054) |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2015-12-01 |