| NPI | 1720514664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MI 6401012221) |
| 171400000X | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2024-05-21 |