| NPI | 1174172936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225600000X Dance Therapist (Licence: NY 0000208) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2019-09-05 |