| NPI | 1588164354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 174200000X | |
| 253Z00000X In Home Supportive Care | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2018-02-18 |
| Last Update Date | 2019-05-31 |