| NPI | 1043627714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 006916-01) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 033965-01) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2026-02-26 |