| NPI | 1992290258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 2255A2300X Specialist/Technologist Athletic Trainer | |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2018-07-02 |