| NPI | 1538514021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OR 22-QMHPC-001176) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YM0800X Counselor, Mental Health (Licence: OR 21-QMHP-R-0512) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2025-04-07 |