| NPI | 1770807968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 217281) |
| 101YM0800X Counselor, Mental Health (Licence: WY PCSW-386) | |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2016-03-16 |