| NPI | 1205311701 |
|---|---|
| Former Name | AMANDA RUSSI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 010760) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2023-07-18 |