| NPI | 1114093549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 4003) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 5672053) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2007-07-08 |