| NPI | 1124004254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY R055967) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NY R055967) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY R055967) | |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2007-07-08 |