| NPI | 1790187219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker Clinical | |
| 251S00000X Community/Behavioral Health | |
| 253J00000X Foster Care Agency | |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2014-09-17 |