| NPI | 1740052240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: LA 5710) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: LA 5710) |
| 101Y00000X Counselor | |
| Enumeration Date | 2023-10-27 |
| Last Update Date | 2023-11-29 |