| NPI | 1609464098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH19813) |
| Additional Taxonomies | 251S00000X (Licence: FL IMH18337) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL IMH18337) | |
| 251B00000X Case Management (Licence: FL IMH18337) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: FL IMH18337) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: FL IMH18337) | |
| Enumeration Date | 2021-01-02 |
| Last Update Date | 2023-08-14 |