| NPI | 1669018537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VA 0732005792) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: VA 0733005430) |
| 103T00000X Psychologist | |
| 171M00000X Case Manager/Care Coordinator | |
| 251S00000X Community/Behavioral Health | |
| 261QE0700X Clinic/Center End-Stage Renal Disease (ESRD) Treatment | |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2019-11-26 |