| NPI | 1881603108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX L8348) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: TX L8348) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2023-05-02 |