| NPI | 1518291889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: PA Bachelor Degree) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: PA Bachelors Degree) |
| 101Y00000X Counselor (Licence: PA Bachelor Degree) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: PA Bachelor Degree) | |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2009-10-10 |