| NPI | 1124569785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 007812) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 383573-1) |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2017-03-15 |