| NPI | 1053970764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 014026) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH25317) |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2026-01-15 |