| NPI | 1972900967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM C-08531) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NM I-08531) |
| Enumeration Date | 2014-11-19 |
| Last Update Date | 2022-04-29 |