| NPI | 1558799478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2013-10-31 |
| Last Update Date | 2022-07-21 |