NPI | 1699040717 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD MH- 1044, MH-1043) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC8470) |
Enumeration Date | 2012-03-22 |
Last Update Date | 2018-02-20 |