| NPI | 1922591650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QR0800X Clinic/Center, Recovery Care |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251X00000X | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2024-08-20 |