NPI | 1902323249 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 240586) |
Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: FL 240878) |
251S00000X Community/Behavioral Health (Licence: FL 240937) | |
Enumeration Date | 2017-08-28 |
Last Update Date | 2025-09-16 |