| NPI | 1548609340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C011451) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC P0010186) |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: OH S.0700770) | |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2020-10-05 |