| NPI | 1174119184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 110547-01) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 110547-01) |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2021-11-11 |