| NPI | 1518422195 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health | 
| Additional Taxonomies | 101Y00000X Counselor | 
| 101YM0800X Counselor, Mental Health | |
| 251E00000X Home Health | |
| Enumeration Date | 2019-02-07 | 
| Last Update Date | 2022-07-21 |