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 |