| NPI | 1578004636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YM0800X Counselor, Mental Health (Licence: LA 25) | |
| 101YM0800X Counselor, Mental Health (Licence: LA 10) | |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2018-07-19 |