| NPI | 1558713289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MT 18599) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MT 18599) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2018-03-17 |