| NPI | 1205474608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 13221) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 103916-01) |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2025-05-14 |