| NPI | 1780023796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH 1200224) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH 1200224) |
| 172V00000X Community Health Worker (Licence: KS 2010053) | |
| 172V00000X Community Health Worker (Licence: OH 2010053) | |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2015-02-10 |