| NPI | 1104248103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 004226) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CT 001638) |
| Enumeration Date | 2014-01-09 |
| Last Update Date | 2014-01-09 |