| 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 (Licence: OR 21-QMHP-R-0512) | 
| 101YM0800X Counselor, Mental Health | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-05-03 | 
| Last Update Date | 2025-05-26 |