| 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 |