| NPI | 1083822746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 118814862) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 004013-1) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2012-06-07 |