| NPI | 1093266801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 013919) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 66PO3958) |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2023-10-10 |