| NPI | 1871645788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904005125) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: VA 0904005125) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2011-03-18 |