| NPI | 1104286111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY 006933) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NY 345889) |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2016-04-25 |