| NPI | 1912290040 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2011-05-23 | 
| Last Update Date | 2021-04-26 |