| NPI | 1710151279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: GA LMSW004491) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2008-04-16 |