| NPI | 1902379605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 268828) |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2021-11-01 |