| NPI | 1053508804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 002775-1) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 17506) |
| 101YP2500X Counselor, Professional (Licence: NJ 37PC00342900) | |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2020-08-24 |