| NPI | 1760521827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 2003032220) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: MO 2003032220) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-08 |