| NPI | 1124771332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 012220) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY P105625) |
| 101YP2500X Counselor, Professional (Licence: NJ 37PC00906600) | |
| Enumeration Date | 2022-01-28 |
| Last Update Date | 2022-12-16 |