| NPI | 1679161905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101Y00000X Counselor | |
| 101YP2500X Counselor Professional | |
| 1041C0700X Social Worker Clinical | |
| 1041C0700X Social Worker Clinical (Licence: VA 0904017103) | |
| 252Y00000X Early Intervention Provider Agency | |
| 171M00000X Case Manager/Care Coordinator | |
| 251S00000X Community/Behavioral Health | |
| 305S00000X Point of Service | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2021-01-03 |
| Last Update Date | 2024-10-01 |