| NPI | 1790667061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM3000X Clinic/Center Medically Fragile Infants and Children Day Care |
| Additional Taxonomies | 101Y00000X Counselor |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 101YP1600X Counselor Pastoral | |
| 174200000X Meals | |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2025-07-25 |
| Last Update Date | 2025-08-07 |