| NPI | 1124514849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 008736) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 30984) |
| 225600000X Dance Therapist (Licence: MD 2040) | |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2018-07-05 |