| NPI | 1972062321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: MI 802268787) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 802268787) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MI 802268787) | |
| 171M00000X Case Manager/Care Coordinator (Licence: MI 802268787) | |
| 251E00000X Home Health (Licence: MI 802268787) | |
| Enumeration Date | 2019-03-15 |
| Last Update Date | 2019-03-15 |