| NPI | 1104223379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY 006175) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CT 2662) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2015-08-17 |