| NPI | 1790142420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2019-03-14 |