| NPI | 1649717463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: HI LCSW-4101) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2023-10-27 |