| NPI | 1932679420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 103TF0000X Psychologist, Family |
| 175T00000X Peer Specialist (Licence: FL 549) | |
| Enumeration Date | 2018-11-28 |
| Last Update Date | 2019-01-25 |