NPI | 1780571257 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AK 2197887) |
Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: 2197887) |
Enumeration Date | 2025-06-18 |
Last Update Date | 2025-06-18 |