| NPI | 1780121095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 171M00000X Case Manager/Care Coordinator | |
| 172V00000X Community Health Worker | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-01-24 |