NPI | 1760936173 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 261QM0801x) |
Enumeration Date | 2016-08-15 |
Last Update Date | 2016-08-15 |