| NPI | 1629474960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: MD LCA1811) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC9910) |
| Enumeration Date | 2014-11-14 |
| Last Update Date | 2020-07-29 |