| NPI | 1831920891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: CA 123346) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA 123346) |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2024-08-12 |