| NPI | 1164914602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 009148) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY P01229) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2019-09-17 |