| NPI | 1164894796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 006667) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY CASAC-30076) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2016-01-11 |