| NPI | 1508309147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: LA 10963) |
| Additional Taxonomies | 104100000X Social Worker (Licence: LA 10963) |
| 171M00000X Case Manager/Care Coordinator (Licence: LA 10963) | |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2023-06-23 |