| NPI | 1982006268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2021-11-02 |