| NPI | 1043723828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY 011679) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YM0800X Counselor Mental Health (Licence: NY 01482-02) | |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2022-01-31 |