| NPI | 1619205788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OK T082350173) |
| Enumeration Date | 2009-11-30 |
| Last Update Date | 2026-02-27 |